Shockwave Therapy or Endoscopic Removal: Which Kidney Stone Treatment Fits Your Stone?

The CT report is one page long, and one line on it changes the shape of your week: a 9 millimeter stone sitting in the lower pole of the left kidney. The urologist slides two leaflets across the desk. One describes a machine that will send pressure waves through your back while you lie on a padded table. The other describes a scope, narrower than a drinking straw, that travels up the same channel your urine travels down. You are asked, gently, which one you would like to think about.

It is a strange thing to be handed a choice you did not know existed. Most people arrive at the question of shock wave lithotripsy vs ureteroscopy knowing only that both are supposed to hurt less than the stone did. What they want is a plain account of what each involves and why a urologist might steer one stone toward the table and a nearly identical one toward the scope.

That account exists, and it rests on a handful of measurable facts about your particular stone rather than on which technology sounds more modern.

Why the same stone can have two right answers

Kidney stones are not one disease. A stone is a crystal that grew in urine that was too concentrated, and the crystal can be calcium oxalate, calcium phosphate, uric acid, struvite or, rarely, cystine. Each behaves differently when you try to break it. Calcium oxalate monohydrate and cystine are notoriously hard; uric acid stones tend to crumble. The stone also has an address. A stone sitting in the kidney’s collecting system is a different engineering problem from one wedged in the ureter, the narrow muscular tube that carries urine from kidney to bladder.

So when a urologist weighs shock wave lithotripsy vs ureteroscopy, the question is never abstract. It is: how large is this stone, where exactly does it sit, how dense does it look on CT, how far is it from the skin, and what is the body around it like? The NHS frames the decision by size and location, reserving shock wave treatment for stones up to about 2 cm and moving to other methods for larger ones. The Mayo Clinic adds that a stone’s composition and the patient’s anatomy shift the balance further.

There is also a human variable. Some people would rather accept a slightly higher chance of needing a second session in exchange for avoiding a general anesthetic and a stent. Others want the stone gone in one visit and are willing to tolerate a few days of stent discomfort to get there. Neither preference is wrong, and evidence-based practice explicitly leaves room for it.

The sections that follow explain what each procedure physically does, which stones usually go where, what recovery looks like, and the questions worth asking before you sign a consent form. The decision itself belongs to you and your treating team, informed by imaging that no article can see.

How shock wave lithotripsy works, in plain language

Extracorporeal shock wave lithotripsy, usually shortened to SWL or ESWL, means breaking a stone from outside the body. Extracorporeal is simply Latin for “outside the body.” You lie on a table, often on your back, sometimes on your side, with a water-filled cushion pressed against the skin over the kidney. Ultrasound or X-ray imaging locates the stone, and the machine is aimed so that thousands of brief pressure pulses converge on a single point.

Each pulse is a sharp rise and fall in pressure, far more sudden than ordinary sound. Where the pulses meet, the stone experiences compression on its front face and a rebound tension on its back face, plus tiny collapsing bubbles at the surface. Repeated a couple of thousand times, this stresses the crystal until it fractures into sand and small gravel. The surrounding kidney tissue, being soft and water-rich, transmits the wave rather than absorbing it, which is why the treatment is possible at all.

According to MedlinePlus, a session usually takes about 45 minutes to 1 hour. You will feel tapping or thumping; most centers use sedation or a light anesthetic so that you stay still and comfortable. There is no incision. Afterward you produce the fragments yourself, passing them in your urine over the following days and weeks.

Two facts matter for the decision. First, the machine cannot make a fragment leave; it can only make it small enough to leave. A stone in a dependent part of the kidney, particularly the lower pole, may break beautifully and then sit there because gravity does not help it out. Second, very hard stones may resist fragmentation, and the Mayo Clinic notes that more than one session is sometimes needed. Those two limitations, drainage and hardness, are the main reasons a urologist reaches instead for a scope.

What actually happens during ureteroscopy

Ureteroscopy uses the body’s own plumbing as the route to the stone. A ureteroscope, a very thin telescope with a light and a working channel, is passed through the urethra, across the bladder and up the ureter. Nothing is cut. Rigid or semi-rigid scopes reach stones in the ureter; a flexible scope with a steerable tip can bend into the kidney itself, which is why the procedure is sometimes called flexible ureteroscopy or retrograde intrarenal surgery.

Once the stone is in view, the urologist has options. Small stones can be captured in a wire basket and drawn out whole. Larger ones are fragmented with a laser fiber threaded down the scope; the laser energy is absorbed at the stone surface and either “dusts” it into fine particles that wash out or breaks it into pieces small enough to basket. The NIDDK describes this as the standard approach for stones the urologist can reach and see directly.

Because the surgeon is looking at the stone, the result is confirmed in real time rather than inferred from imaging a few weeks later. That visual certainty is ureteroscopy’s central advantage and the reason it is so often chosen for ureteral stones and for dense stones that shock waves struggle with.

The procedure is done under general or spinal anesthesia, and most people go home the same day, according to the Cleveland Clinic. Before finishing, the urologist often places a ureteral stent, a soft hollow tube that runs from kidney to bladder and keeps the ureter open while swelling settles. The stent is the part of ureteroscopy people are least prepared for and most vocal about afterward; it gets its own section below. Occasionally, if the ureter is too narrow to admit the scope safely, the surgeon places a stent first and returns for the stone a couple of weeks later. That is a planned staging step, not a failure.

Shock wave lithotripsy vs ureteroscopy: which stones usually go where?

Urologists sort stones along four axes: size, location, density and the body around them. Guideline-level practice, as summarized by the NHS and NIDDK, tends to follow a pattern rather than a rule.

Size. Stones under roughly 5 mm often pass without any procedure at all. Between about 5 mm and 2 cm sits the territory where shock wave lithotripsy vs ureteroscopy is a genuine choice; both are reasonable, and the other factors decide. Above about 2 cm, both the NHS and the Mayo Clinic describe percutaneous surgery through the back as the usual route, because neither shock waves nor a scope clears that much material efficiently.

Location. Stones in the ureter, particularly the lower third near the bladder, are commonly treated with ureteroscopy because the scope reaches them easily and shock waves can be hard to target through the pelvic bone. Stones in the upper kidney with good drainage suit lithotripsy well. Stones in the lower pole are the awkward middle case: they fragment, then linger. Many urologists lean toward ureteroscopy for lower pole stones approaching 1 cm for exactly that reason.

Density. On CT, stone density is measured in Hounsfield units. Very bright, dense stones and stones known or suspected to be cystine or calcium oxalate monohydrate respond poorly to shock waves; a laser does not care how hard the stone is.

The body around the stone. A long distance from skin to stone weakens the shock wave by the time it arrives, which can make lithotripsy less effective in people with larger body habitus; this is a physics observation, not a judgment. Anatomical quirks such as a horseshoe kidney or a narrow ureter, prior surgery, or a stone behind a blockage also push toward the scope.

Your urologist will map your stone onto these axes. If two options remain, your preferences about anesthesia, stents and the chance of a repeat session become the deciding factor.

Who is usually asked to wait before any procedure

Not every stone earns a procedure. The NHS and NIDDK both describe a first tier of care called observation, sometimes with medication, for stones small enough that the body is likely to expel them. The logic is simple: a procedure carries risks, and a stone that leaves on its own carries only the risk of the days it takes.

Observation usually involves drinking enough fluid to keep urine pale, taking pain relief prescribed by the clinician, and straining urine to catch the stone so it can be analyzed. Your urologist may prescribe a medicine from the alpha-blocker class, which relaxes smooth muscle in the lower ureter and is thought to widen the channel slightly and ease the stone’s passage; whether it is appropriate for your stone, and for how long, is entirely a prescribing decision. Follow-up imaging is set for a few weeks out, and the Mayo Clinic notes that small stones may take days to weeks to pass.

Some people are asked to wait for a different reason: the timing is wrong for the procedure itself. MedlinePlus lists pregnancy, bleeding disorders and blood-thinning medication as reasons shock wave lithotripsy is generally avoided, because the waves can bruise the kidney. An active urinary infection is a reason to delay either procedure until it is treated, since instrumenting an infected system can push bacteria into the bloodstream. In those situations the urologist may place a stent or a drainage tube first to protect the kidney and return for the stone later.

Waiting is not the same as doing nothing. People on observation are asked to seek urgent care if pain becomes uncontrollable, fever develops, or they stop passing urine, because a stone that blocks an infected or solitary kidney is an emergency regardless of size. The waiting period has an end date too: if the stone has not moved by the follow-up scan, or the pain is not settling, the conversation about shock wave lithotripsy vs ureteroscopy begins in earnest.

Lithotripsy vs ureteroscopy at a glance: comparison table

The table below distills the practical differences described by the NHS, Mayo Clinic, MedlinePlus and NIDDK. It is a map, not a verdict; individual anatomy and stone chemistry override every row.

Feature	Shock wave lithotripsy	Ureteroscopy
How the stone is reached	From outside, through the skin, with focused pressure waves	From inside, via urethra and bladder, with a thin scope
Incision	None	None
Typical anesthesia	Sedation or light general	General or spinal
Usual stone size range	Up to about 2 cm (NHS)	Small to about 2 cm, larger with staging
Best-suited location	Kidney and upper ureter with good drainage	Any part of the ureter; kidney, including lower pole
Hard, dense stones	May resist fragmentation	Laser is largely indifferent to hardness
Who removes the fragments	You, by passing them over days to weeks	The surgeon, by basket or dusting, during the procedure
Stent	Usually not needed	Often placed for a short period
Chance of a second session	Higher; repeat sessions sometimes needed (Mayo Clinic)	Lower; result confirmed visually
Main risks	Blood in urine, bruising, fragment blockage, rarely kidney bleeding	Stent discomfort, infection, ureter injury, rare stricture
Usual return to routine	About 1 to 2 days (MedlinePlus)	A few days, longer if stent is uncomfortable
Often avoided when	Pregnant, on blood thinners, bleeding disorder, active infection	Active infection; very large stone burden

Two rows deserve emphasis. The “who removes the fragments” row explains most of the difference in recovery experience: after lithotripsy your body is still doing work for weeks. The “chance of a second session” row explains why urologists often favor ureteroscopy when a person cannot easily return, needs the stone resolved before another treatment, or has already had one unsuccessful lithotripsy.

Ureteroscopy with stent placement: what the stent is and why it bothers people

A ureteral stent is a soft plastic tube, roughly the diameter of a piece of spaghetti, with a curl at each end. One curl sits in the kidney, the other in the bladder. Its job is mechanical: after the ureter has been stretched by a scope and irritated by stone fragments, it swells, and swelling in a tube that narrow can block it. The stent keeps urine flowing while the lining heals and lets any leftover dust wash past without lodging.

The Cleveland Clinic and NIDDK both describe the stent as commonly placed after ureteroscopy and left for a short period, typically days to a few weeks, before being removed in the clinic. Removal takes minutes: the urologist grasps the bladder end with a small scope, or, if a string was left attached, the string is pulled. Some people are given the string and shown how to remove the stent at home on a set day; others prefer a clinic visit. Either is standard.

Why do people complain about it so much? The bladder end rubs the bladder lining every time the bladder empties, which produces urgency, frequency, a burning sensation and sometimes a dull flank ache when you pass urine as pressure travels briefly back up the tube. Blood-tinged urine is common while a stent is in and usually not a concern on its own. None of this signals a problem with the surgery; it signals a foreign object in a sensitive place.

Not every ureteroscopy needs a stent. For small, uncomplicated stones removed without much manipulation, many urologists skip it. Ask beforehand whether a stent is likely, how long it would stay, and how it will be removed, because a forgotten stent left in for months can itself become encrusted with stone. Write the removal date down where you will see it.

Is shock wave lithotripsy painful, and what are the risks of each option?

During lithotripsy, with sedation, most people describe a rhythmic tapping or flicking sensation rather than sharp pain. Afterward the picture changes. The kidney has been bruised from the inside, so a dull ache in the flank for a day or two is expected, and blood in the urine is very common in the first days, according to MedlinePlus. Passing the fragments is the part that can hurt: a piece of gravel moving down the ureter produces the same colicky, wave-like pain the original stone did, only briefer. Urologists sometimes place a stent before lithotripsy for larger stones precisely to keep fragments from stacking up in the ureter, a complication called steinstrasse, German for “stone street.”

Less common lithotripsy risks listed by MedlinePlus and the Mayo Clinic include bleeding around the kidney, infection, and skin bruising over the treatment site. A blocked ureter from fragments occasionally needs a follow-up procedure. Long-term effects on blood pressure and kidney function have been studied for decades; the evidence is mixed and reassuring for most people, but it is a fair question to raise if you have a single kidney or existing kidney disease.

Ureteroscopy trades fragment pain for stent symptoms. Its procedure-specific risks include urinary tract infection, injury to the ureter lining, and, uncommonly, a small tear that requires a stent for longer. Rarely, the ureter heals with scar tissue that narrows it, a stricture, which shows up months later and may need treatment. Because it involves general or spinal anesthesia, the usual anesthetic risks apply.

Both procedures share one hazard: infection spreading to the bloodstream, which is why urine is tested first and antibiotics are given beforehand in many protocols. Both also share a modest chance of missing a fragment that seeds a future stone, which is why follow-up imaging matters. Your urologist will weigh these risks against your specific stone and health history; the numbers that apply to you depend on details only they can see.

Lithotripsy vs ureteroscopy recovery time: the days and weeks that follow

After shock wave lithotripsy, MedlinePlus notes that many people return to normal activities within about 1 to 2 days. The first 24 hours usually bring flank soreness, pink or reddish urine and fatigue from the sedation. Over the next several days the fragments begin to move. Some pass unnoticed as sand; others announce themselves with a few hours of cramping pain that eases once the piece reaches the bladder. You will likely be asked to strain your urine, drink steadily, and stay reasonably active, since walking helps gravity do its part. Follow-up imaging, often a plain X-ray or ultrasound, is scheduled a few weeks out to check whether the kidney is clear. If it is not, the options are to wait longer, repeat the session, or switch to ureteroscopy.

After ureteroscopy, most people go home the same day. The first two or three days are dominated by stent symptoms if one was placed: burning, urgency and a flank twinge when you urinate. Blood in the urine is usual for several days and may come and go with activity. Many people are back at a desk job within a few days, though heavy lifting and long drives are often deferred until the stent is out. The stent removal appointment, days to a few weeks later, is the real end point of recovery; symptoms typically fade within a day or two of removal. A follow-up scan a few weeks after that confirms the result.

Both timelines stretch in the same situations: a urinary infection, a large stone burden, a solitary kidney, or a job that involves manual work. Both also share a quieter phase most people forget about. Once the stone is analyzed, a conversation about why it formed and how to prevent the next one is the part of recovery with the longest payoff. Treating the stone you have is a procedure; preventing the one you might grow is a habit.

When neither is the answer: percutaneous surgery and other routes

For stones larger than about 2 cm, or for several stones filling the kidney’s branches, the NHS and Mayo Clinic describe percutaneous nephrolithotomy, or PCNL, as the usual approach. Percutaneous means “through the skin”: a small incision is made in the back, a tract is created directly into the kidney, and a wider scope removes the stone with ultrasound or laser energy. It is more invasive than either lithotripsy or ureteroscopy, and the Mayo Clinic notes a hospital stay of about one to two days. What it offers in exchange is efficiency: a large stone that would take several ureteroscopies, or many lithotripsy sessions, can often be cleared in one operation.

Very rarely, when anatomy makes every scope-based route impossible, open or laparoscopic surgery is used. In modern practice this is uncommon and reserved for specific circumstances that your urologist would explain in detail.

There is also the opposite end of the spectrum: no procedure at all, but dissolving therapy. Pure uric acid stones can sometimes be shrunk by making the urine less acidic with a prescribed alkalinizing medicine, because uric acid crystals dissolve in less acidic urine. This works only for that stone type and only under a clinician’s supervision with monitoring, and it does not apply to calcium stones, which make up the majority.

Where does this leave someone weighing shock wave lithotripsy vs ureteroscopy? Mostly reassured. The fact that your urologist is offering those two options rather than PCNL means your stone burden is in the range where minimally invasive treatment is appropriate. It also means the choice between them is real, not a formality, and worth a second conversation if anything about the first one felt rushed.

What people often get wrong about kidney stone size for lithotripsy and beyond

“Shock wave therapy is the gentle option, so it must be the right first step.” It avoids a scope, but it hands the rest of the job to your body. For a lower pole stone or a dense stone, that can mean weeks of fragment passage and then a second procedure anyway. Gentle on the day is not the same as gentle overall.

“Bigger stones always need bigger surgery.” Size matters, but the NHS’s rough 2 cm threshold is a guide, not a wall. A 1.5 cm soft stone in a well-draining kidney may suit lithotripsy; a 7 mm rock-hard stone in the lower pole may not.

“Ureteroscopy involves a cut.” It does not. The scope travels through natural openings. The word “surgery” attached to it refers to the anesthetic and the operating room, not to an incision.

“Once the stone is gone, the problem is over.” Stones recur. The Mayo Clinic and NIDDK both stress that analyzing the stone and adjusting fluids and diet is how you lower the odds of the next one. The procedure treats one stone; it does not change the urine that grew it.

“Blood in my urine after the procedure means something went wrong.” Pink or red urine for several days after either procedure is expected, according to MedlinePlus. Heavy bleeding with clots, or bleeding that worsens instead of fading, is different and belongs in the red-flag list below.

“Drinking cranberry juice or a special tea will flush the stone out.” There is no good evidence that any specific beverage dissolves or expels stones. Plain water, in the volume your clinician suggests, is what the evidence supports.

“The newest machine or laser is the deciding factor.” Technology has improved both procedures, but the decision still turns on your stone’s size, position and density and on your health. A well-matched procedure on ordinary equipment beats a poorly matched one on the latest model.

Questions to ask your care team before choosing

A good consultation should leave you able to explain, in your own words, why one option fits your stone better. These questions tend to surface the reasoning.

• How large is my stone, where exactly is it, and how dense does it look on CT? Which of those three factors weighs most in your recommendation?
• If I chose shock wave lithotripsy, how likely is it that I would need a second session for a stone like mine, and what would happen if fragments got stuck?
• If I chose ureteroscopy, would you expect to place a stent? For how long, and how would it be removed?
• What kind of anesthesia does each option involve for me, given my other health conditions?
• Are there reasons in my history, such as blood thinners, a bleeding disorder, pregnancy, a single kidney or previous urinary surgery, that rule out or favor one approach?
• How will we confirm the kidney is clear afterward, and when?
• What symptoms after the procedure would you consider normal, and which should make me call?
• Will the stone or fragments be sent for analysis, and when will we talk about preventing the next one?
• If I do nothing for now, what is the realistic chance this stone passes on its own, and how long would you be comfortable waiting?
• Is there anything about my work, travel or caregiving responsibilities that should influence the timing or the choice?

Bring someone with you if you can, and ask for the imaging report. Having the stone’s measurements in hand makes every later conversation shorter. If the recommendation changes between the first appointment and the day of the procedure, ask why; sometimes updated imaging or a urine result shifts the balance, and you deserve to hear the reasoning. The final decision rests with you and your treating urologist, and a thoughtful team will welcome the questions.

When to call your doctor

Most recovery from either procedure is uneventful, and most symptoms are the expected soreness, stent irritation and pink urine described above. A short list of signs, drawn from the guidance published by MedlinePlus, the Mayo Clinic and the NHS, means you should contact your urology team the same day or seek emergency care if the office is closed.

• Fever, chills or shaking, which can signal infection in a kidney whose drainage has been disturbed and can progress quickly.
• Pain that is severe and not controlled by the pain relief you were prescribed, or pain that steadily worsens rather than easing.
• Inability to pass urine, or passing only small amounts despite drinking normally, especially if you have one kidney.
• Urine that is heavily bloody with clots, or bleeding that increases after the first few days instead of fading.
• Persistent vomiting that stops you keeping fluids down.
• Feeling faint, unusually short of breath, or confused.
• A stent that appears to have slipped, a string that has come loose, or a stent removal date that has passed without an appointment.

If you were placed on observation without a procedure, the same list applies, with one addition: a stone that has not passed by the date your urologist set for follow-up should prompt a call even if you feel well, because a silent obstruction can damage a kidney without much pain.

When in doubt, call. Urology teams would far rather field a question about pink urine than see a preventable infection arrive in the emergency department. Keep the after-hours number somewhere visible from the day of your procedure until your follow-up scan confirms the kidney is clear.

Preventing the next stone: what the evidence actually supports

Whichever route clears this stone, the urine that made it is still yours. The Mayo Clinic and NIDDK are consistent about what lowers recurrence, and none of it requires a procedure.

Fluid comes first. Dilute urine gives crystals less chance to meet. The NHS suggests drinking up to about 3 liters of fluid spread across the day, with water as the mainstay; the practical test is urine that stays pale. Hot climates, heavy exercise and physically demanding jobs raise the target because sweat steals water that would otherwise become urine.

Salt matters more than most people expect. Sodium pulls calcium into the urine, so a high-salt diet raises urinary calcium even when dietary calcium is unchanged. Reducing processed and restaurant foods is the lever most people can actually pull.

Calcium itself is misunderstood. Cutting dietary calcium tends to increase oxalate absorption and can raise stone risk; the NIDDK advises normal calcium intake from food rather than restriction. Calcium supplements are a different question and worth raising with your clinician if you take them.

Oxalate-rich foods such as spinach, nuts and some teas are relevant for calcium oxalate formers, though moderation and pairing them with calcium-containing foods usually matters more than elimination. Animal protein raises uric acid and lowers urinary citrate, a natural crystal inhibitor; citrus fruit adds citrate back.

Stone analysis is the step that turns general advice into specific advice. Once the laboratory reports the stone’s chemistry, and a 24-hour urine collection shows what your kidneys are excreting, your clinician can tailor the plan and, for some people, prescribe a medicine that alters urine chemistry. Those choices, and whether they suit you, belong to the prescribing team. What belongs to you is the water bottle, the salt shaker and the follow-up appointment.

Frequently asked questions

Is shock wave lithotripsy painful during the procedure?

With sedation or a light anesthetic, most people feel rhythmic tapping rather than sharp pain during the session. Discomfort tends to come afterward: a dull flank ache for a day or two, pink urine, and colicky pain when fragments move down the ureter. MedlinePlus notes many people return to routine within about 1 to 2 days, though fragment passage can continue for weeks.

What is the usual kidney stone size for lithotripsy?

The NHS describes shock wave lithotripsy as an option for stones up to about 2 cm, with larger stones usually treated by percutaneous surgery. Size alone does not decide, though. Very dense stones, stones in the lower pole of the kidney, and stones far from the skin respond less well, so a smaller stone with those features may still be steered toward ureteroscopy.

How long does lithotripsy vs ureteroscopy recovery time usually take?

After lithotripsy, MedlinePlus reports most people resume normal activity within about 1 to 2 days, while fragments pass over the following weeks. After ureteroscopy, most people go home the same day and feel largely normal within a few days, but stent symptoms persist until the stent is removed, typically days to a few weeks later. Both timelines lengthen with infection or a large stone burden.

Does ureteroscopy with stent placement always happen?

No. Many urologists skip the stent after a short, uncomplicated ureteroscopy for a small stone. A stent is more likely when the ureter was stretched or irritated, when many fragments remain, when there is swelling or infection, or when a second procedure is planned. Ask beforehand whether a stent is expected, how long it would stay, and how it will be removed.

Can a kidney stone come back after either treatment?

Yes. Both procedures treat the stone you have; neither changes the urine chemistry that formed it. The Mayo Clinic and NIDDK emphasize stone analysis, adequate fluid intake, and dietary adjustments, particularly lower salt and normal food calcium, as the evidence-supported ways to reduce recurrence. Some people are also prescribed medicines that alter urine chemistry, a decision for the treating clinician.

Why might a urologist prefer ureteroscopy for a stone in the ureter?

The scope reaches the ureter directly and shows the stone on a screen, so removal is confirmed on the spot. Shock waves can be hard to aim at lower ureteral stones because the pelvic bone sits in the way, and fragments in a narrow ureter can stack up. For those reasons the NIDDK describes ureteroscopy as a common choice for ureteral stones.

Why is shock wave lithotripsy avoided in pregnancy or on blood thinners?

The pressure waves bruise the kidney from the inside, which is acceptable in most people but risky when clotting is impaired, because bleeding around the kidney can be significant. MedlinePlus lists pregnancy, bleeding disorders and anticoagulant medication as reasons the procedure is generally not used. Ureteroscopy or temporary drainage is usually discussed instead; never adjust a blood thinner without your prescriber’s guidance.

What happens if shock wave lithotripsy does not clear the stone?

Follow-up imaging a few weeks later shows whether fragments remain. The Mayo Clinic notes that a repeat session is sometimes needed. If the stone proved too hard, or fragments have settled in the lower pole, the urologist may recommend switching to ureteroscopy rather than repeating lithotripsy. An unsuccessful first session is common enough that it is built into the counseling.

Will I be awake during ureteroscopy?

Usually not. Ureteroscopy is performed under general or spinal anesthesia so that you stay still and comfortable while the scope passes up the ureter, according to the Cleveland Clinic. Most people are discharged the same day once they are drinking, passing urine and pain is controlled. The anesthetic type is chosen with the anesthesia team based on your health history.

How do I know whether my stone is hard enough to resist shock waves?

CT scans measure stone density in Hounsfield units, and very bright, dense stones tend to fragment poorly. A previous stone analysis showing calcium oxalate monohydrate, cystine or brushite also predicts hardness, while uric acid stones usually crumble easily. Your urologist reads these clues from your imaging and history; ask directly what your stone’s density suggests about lithotripsy.

References

• NHS: Kidney stones, Treatment
• MedlinePlus Medical Encyclopedia: Lithotripsy
• NIH NIDDK: Treatment for Kidney Stones
• Cleveland Clinic: Kidney Stones

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.